Load and shift test for the shoulder

Procedure: The subject sits upright with no upper trunk stabilization and the involved arm resting at the side. The examiner stands slightly behind the subject while stabilizing the clavicle and scapula with one hand. With the other hand, the examiner grasps the subject's humeral head with the thumb posteriorly. The examiner's remaining fingers are located anteriorly.

The Examiner places an axial load along the shaft of the humerus in an attempt to compress the humeral head into the glenoid fossa. With the load applied, the examiner translates the humeral head, first anteriorly and then posteriorly.

Results: An anterior or posterior translation of the humeral head greater than 25% of the diameter of the humeral head when a load is applied is considered to be a positive test. The test should be repeated bilaterally for comparative findings.

Special Considerations: Translation between 25 and 50% has been described as being a grade I positive test. Greater than 50% translation associated with a subsequent reduction of the humeral head is considered grade II, while the same amount of translation without reduction is recognized as grade III and the most serious type of a shift.

References:

Konin, Jeff G., Denise L. Wiksten, Jerome A. Isear, and Holly Brader. Special Tests for Orthopedic Examination. 3rd ed. Thorofare, NJ: SLACK Incorporated. 2006. 35-38. Print.rences


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